Heart failure is the final common pathway of most primary cardiovascular diseases, including coronary atherosclerosis, hypertension, cardiomyopathy, myocarditis, diabetes, and valvular and congenital heart malformations. Most treatments slow the course of these primary diseases but do not abolish them. As a result, an increasing proportion of the US population is living with heart disease and is at risk for heart failure. Approximately 400 000 new cases of heart failure occur annually, and recent estimates (1993) of its prevalence demonstrate the enormous burden exacted on the public: 4.7 million patients, with 1.5 million people younger than 65 years of age, and direct healthcare costs (drugs, nursing home care, professional services) totaling $17.8 billion each year. These numbers will likely increase as the US population ages.

In recognition of this national health problem, the National Heart, Lung, and Blood Institute (NHLBI) convened a Task Force on Research in Heart Failure and released the findings in 1994 to chart the course for future research. Given the explosion of new information and ideas, a Special Emphasis Panel (SEP) on Heart Failure Research was held on May 20, 1996, in Bethesda, Md, to follow up and focus the broad task force recommendations. The framework to conduct future research as recommended by these expert panels of extramural scientists is essential to promoting the needs of the biomedical community and properly committing the Institute's scarce resources.